Are pediatric emergency medicine training programs adequately preparing graduates for involvement in EMS?

Objective: To examine the level of involvement in pre-hospital care for children by faculty and fellows of teaching hospitals with a Pediatric Emergency Medicine (PEM) fellowship. In addition, we hypothesized that a divisional faculty member's involvement as principal investigator (PI) on an EMSC grant would not impact divisional involvement in on or off-line medical direction.

Design: Cross-sectional national survey.

A prospective trial of telepathology for intraoperative consultation (frozen sections).

Telepathology is a maturing technology that, for a variety of reasons, has not been widely deployed. In addition, clinical validation is relatively modest compared with accepted telemedicine applications such as teleradiology. A prototype telepathology system (Tele-Path(sm)) featuring high-resolution images selected from a remote microscope site has been developed at the University of Alabama at Birmingham (UAB).

Natural history of arteriovenous grafts in hemodialysis patients.

Most hemodialysis patients in the United States have an arteriovenous graft as their vascular access. Grafts have a relatively short life span and are prone to recurrent stenosis and thrombosis, requiring multiple salvage procedures to maintain their patency. There is little information in the literature regarding the clinical factors that determine graft survival and complications.

Energy expenditure and free-living physical activity in black and white women: comparison before and after weight loss.

Background: The prevalence of obesity is higher in black than in white women. Differences in energy economy and physical activity may contribute to this difference.

Objective: The objective of this study was to compare free-living energy expenditure and physical activity in black and white women before and after weight loss.

The p44S10 locus, encoding a subunit of the proteasome regulatory particle, is amplified during progression of cutaneous malignant melanoma.

Gene amplification is frequently present in human tumors, although specific target genes relevant to many amplified loci remain unidentified. An expression cloning assay enabled identification of a candidate oncogene derived from human chromosome 3p14.1.

Hu antigen specificities of ANNA-I autoantibodies in paraneoplastic neurological disease.

Despite a broad clinical spectrum, paraneoplastic enecephalomyelitis/sensory neuronopathy (PEM/SSN) is characterized by the presence of a common autoantibody, referred to as anti-Hu or type I anti-neuronal nuclear antibody (ANNA-1). The target of these antibodies is a family of four Hu antigens: three (Hel-N1, HuC, HuD) are neural-specific, while the fourth (HuR) is ubiquitous. Here, we have analysed by enzyme-linked immunosorbent assay (ELISA) the immunoreactivity of all four Hu antigens in serum from 75 patients with ANNA-1 autoantibodies and looked for clinical correlations.

Predictors of adequacy of arteriovenous fistulas in hemodialysis patients.

Background: Dialysis access procedures and complications represent a major cause of morbidity, hospitalization, and cost for chronic dialysis patients. To improve the outcomes of hemodialysis access procedures, recent clinical guidelines have encouraged attempts to place an arteriovenous (A-V) fistula, rather than an A-V graft, whenever possible in hemodialysis patients. There is little information, however, about the success rate of following such an aggressive strategy in the prevalent dialysis population.

A simple "step-test" protocol for identifying suspected unrecognized exercise-induced asthma (EIA) in children.

The purpose of this study was to demonstrate that a simple submaximal "step-test" could be used as an exercise challenge to identify elementary school students with suspected but undiagnosed asthma. This article also describes a protocol for exercise testing that can be used in epidemiological evaluations. School age children grades 1-4 with suspected but undiagnosed asthma were identified by a 12-item questionnaire completed by a parent or guardian.

Phase I/IIa study of concurrent paclitaxel and cisplatin with radiation therapy in locally advanced non-small cell lung cancer: analysis of early and late pulmonary morbidity.

Recent efforts to improve survival outcome in patients with locally advanced non-small cell lung cancer have focused on the use of chemoradiotherapy regimens containing vinblastine/cisplatin or etoposide/cisplatin. However, the overall treatment outcome with these regimens remains poor, emphasizing the need for new therapeutic options. Based on the activity of paclitaxel in advanced non-small cell lung cancer, its additive cytotoxicity with cisplatin, and the radiation-sensitizing effect of both agents, a phase I/IIa study was designed to examine the feasibility of paclitaxel/cisplatin concurrently with conventional thoracic irradiation in patients with locally advanced tumors.

A comparison of carotid angioplasty with stenting versus endarterectomy with regional anesthesia.

Introduction: Percutaneous transluminal angioplasty with stenting (PTAS) has been considered a potential alternative to carotid endarterectomy (CEA) for stroke prevention. Interventionalists have suggested that PTAS carries less anesthetic risk than CEA. The treatment of carotid stenosis with local or regional anesthesia (LRA) allows direct intraprocedural neurologic evaluation and avoids the potential risks of general anesthesia.

Retinal venous oxygen saturation correlates with blood volume.

Objectives: To evaluate the sensitivity of retinal venous O2 saturation (SrvO2) for early blood loss and reinfusion. A secondary objective was to measure the correlation between SrvO2 and mixed venous O2 saturation (SvO2) during blood loss and reinfusion.

Methods: Seven anesthetized swine were bled at 0.

A cost comparison of balloon angioplasty and stenting versus endarterectomy for the treatment of carotid artery stenosis.

Purpose: Percutaneous transluminal angioplasty with stenting (PTAS) of the carotid artery has been advocated as an alternative treatment for high-grade stenosis. Rationale for this approach includes less morbidity, shorter recovery, and lower cost when compared with carotid endarterectomy (CEA).

Methods: The clinical results and hospital charges of patients who underwent elective treatment for carotid stenosis were reviewed.

Nutritional status of urban homebound older adults.

The purposes of this study were to assess comprehensively the nutritional status of frail older adults living in an urban area and to identify factors associated with nutritional insufficiency. Subjects were 49 adults aged > or = 65 y followed by the Jefferson County Home Health Department. Twenty-nine percent of the women and 63% of the men had a body mass index (BMI; in kg/m2) < 24.

Effects of small-peptide and whole-protein enteral feedings on serum proteins and diarrhea in critically ill patients: a randomized trial.

Background: It has been proposed that enteral feeding formulas containing small peptides are more efficacious and better tolerated than whole-protein formulas in critically ill patients.

Methods: Intensive care unit patients were stratified with regard to treatment with antibiotics and serum albumin and randomized to treatment with a small-peptide enteral diet or an isoenergetic, isonitrogenous whole-protein diet for 10 days. To assess efficacy, we measured serum prealbumin and fibronectin, and to assess tolerance, we monitored the incidence of diarrhea.